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STATE OF COLORADO <br />MINED LAND RECLAMATION BOARD <br />PARTY STATUS FORM <br />In the matter of File No. M-~QQj_-~_, Permit/Permit Amendment <br />Name of Operator/Applicant and Site: N i Y Sand ~ G raJ~2.1 M ~'nP_ <br />RECEIVED <br />AUG 2 4 2001 <br />Oivisian of Minerals and Geology <br />_ I request that I be named as a party <br />I request that I not be named as a party <br />I understand that I have party status <br />I request I be withdrawn from party status <br />I wish [o address the Boazd at the formal <br />hearing, if held, as a non-party <br />approval or denial, there may not be an opportunity for any person to address the Board on any issues related <br />to the application. If all objecting parties withdraw their objection after the above referenced date, the Board <br />may still hold a formal hearing, however the Board is not obligated to consider any issues raised by a party that <br />has withdrawn.) <br />Regardless of a party status, the Division thoughtfully considers each issue submitted in writing to the Division and <br />provides a response to those issues in the Division's "Rationale For Recommendation ". The "Rationale" is available to <br />any person by contacting the Division, For persons who do not wish to become a party or withdraw as a party in this <br />matter, please contact the Division for information on application status. <br />(Please provide [he following information if you have or wish to have party status, thank you.) <br />--Tov~h o~ ~P1~.e.v~~le c ) <br />Printed Name Home Phone # <br />"400 ,9~,a,,,,~, (~,u.e-. (970) ^t8s aa~s <br />Address Work Phone # <br />~Art.Q~e, ~ ~0(oSl-'1503 (9'70) r1d'5-ay~lo <br />City, State Zip Code FAX # <br />E-Mail Address <br />"`°~'-~, X00 <br />Date <br />If you are not now a party and you wish to be named as a party, please provide the following: <br />• How you may be affected or aggrieved by the Boazd's decision if the Bord decides to approve the application. <br />(Please attach additional pages if needed) <br />Please explain your opposition [o the matter, including a specific description of the issues that you feel need [o be <br />addressed a[ the Formal Boazd Hearing and why. <br />(Please attach additional pages if needed) <br />